Federal Reports

The VA Office of Inspector General (OIG) conducted a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the William Jennings Bryan Dorn VA Medical Center (the Facility). The review covered key clinical and administrative processes associated with promoting quality care—Leadership and Organizational Risks; Quality, Safety, and Value; Credentialing and Privileging; Environment of Care; Medication Management: Controlled Substances Inspection Program; Mental Health Care: Post-Traumatic Stress Disorder Care; Long-Term Care: Geriatric Evaluations; Women’s Health: Mammography Results and Follow-Up; and High-Risk Processes: Central Line-Associated Bloodstream Infections. The Facility has stable executive leadership and active engagement with employees as evidenced by high satisfaction scores. Organizational leaders support patient safety, quality care, and other positive outcomes (such as initiating processes and plans to maintain positive perceptions of the Facility through active stakeholder engagement). The OIG’s review of accreditation organization findings, sentinel events, Patient Safety Indicator data, and Strategic Analytics for Improvement and Learning (SAIL) results did not identify any substantial organizational risk factors. The senior leadership team was actively engaged and knowledgeable about selected SAIL metrics but should continue to take actions to improve care and performance of selected SAIL metrics, particularly Quality of Care and Efficiency metrics likely contributing to the “2-Star” rating. The OIG noted findings in four of the eight areas of clinical operations reviewed and issued eight recommendations that are attributable to the Chief of Staff and Associate Director. The identified areas with deficiencies are: 1) Credentialing and Privileging • Focused and Ongoing Professional Practice Evaluation processes 2) Environment of Care • Core members’ participation in environment of care rounds • Environmental cleanliness • Medical equipment safety 3) Mental Health Care • Timely completion of suicide risk assessments 4) Long-Term Care • Geriatric evaluation program performance improvement and oversight • Identification and implementation of geriatric plan of care interventions

The U.S. Postal Service considers mail to be delayed when it is not processed in time to meet the established delivery day. Mail processing facilities are required to complete daily mail counts and self-report on-hand mail, delayed mail, late-arriving mail, and mail processed after the cut-off time and enter the information into the Web Mail Condition Reporting System (MCRS). The objective of our audit was to determine the accuracy of delayed mail reporting at three selected facilities in the Great Lakes Area.

The Postal Accountability and Enhancement Act of 2006 was enacted at a time when mail was a primary vehicle for advertising, correspondence, and business transactions. Since that time, consumer behavior and the marketing industry have significantly changed. Digital advertising, electronic bill pay, and email correspondence have impacted mail volume, resulting in a 40 and 24 percent decline in First-Class and Marketing Mail volume, respectively, since 2006. In fiscal year (FY) 2017, First-Class Mail volume declined by 2.5 billion pieces and Marketing Mail volume declined by 2.6 billion pieces, primarily due to digital diversion. Our objective was to assess the effectiveness of the U.S. Postal Service’s business customer retention strategies.

Our objective was to determine whether the U.S. Postal Service’s Expansion of Package Sorters capital investment achieved expected savings and performance metrics.